SCORE Journal Issue - Feb 2017

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CONCUSSIONS: A GROWING CONCERN IN MOTORSPORTS
Experts, Researchers and Safety Gear Manufacturers Try to Find Answers
By Stephen Romero
Photography: Courtesy of Impact Racing, Julia Daly and Dr. Stephen Olvey
Somewhere in America, a former NFL player lays in a hospice because of a condition that may have been preventable. If you saw the movie “Concussion” with actor Will Smith portraying Dr. Bennet Omalu’s discovery, you already know that receiving an injury like this in football is a serious hazard. The same can be said for bringing this information to light within the off-road motorsports industry, where it is important to understand and find solutions to preventing this type of head trauma.
Unfortunately, chronic traumatic encephalopathy, or CTE as it is known, is one of the least understood medical conditions attributed to head and brain injuries in all forms of sports. That’s beginning to change, however, as researchers uncover the link between CTE and repeated brain injuries like concussions.
Season after season of being jarred, tackled, hit and pummeled on the football field, a growing number of middle-aged NFL players are paying the price for years of head and brain trauma by succumbing to their injuries, often early in life. The same can be said for off-road motorsports racers, who are under constant jarring motions while racing on off-road terrain, and who can receive head trauma in an accident or roll-over. Hope for prevention of CTE comes through education of identifying the early detection of mild concussions, and the proper use approved safety equipment.
It’s important to understand that concussions happen just as easily any sport. According to sources in the field of brain and head injuries, even though motorsports racers are required to use much more safety equipment than football players, they are just as susceptible to the deadly effects of CTE; especially if concussions are not reported, treated properly or are misdiagnosed.
SCORE Journal contacted the leading experts in the field of brain injuries in motorsports and learned more about this condition and what is being done to minimize its effects. To this point, one the most prominent medical doctors to speak out about CTE and concussions in motorsports is Dr. Stephen E. Olvey, a consultant to FIA and IndyCar. “I became the assistant medical director of IndyCar back in the 1960s, and I later became the director of medical affairs for CART for 25 years and went on to work with Dr. Terry Trammel,” said Olvey. “Twenty years ago, after a motorsports accident when a driver didn’t look to be too badly hurt, we would just say he was lucky he just had a concussion. But now we know that concussions are very serious, especially if you have had too many of them quite close together.
Concussions are unfortunately very prominent in motorsports because many start off young, competing in go-karts, UTVs, motorcycles, and buggies, when they are five or six years old. Many are at risk because their brain is still developing and they can have minor concussions on a relatively frequent basis as they grow. A lot of time they don’t even know they had concussions, not even their parents know it.”
Now doctors and researchers like Olvey understand how to better treat mild concussions before they become chronic in the case of CTE, where the patients start to suffer from early onset dementia. “Those of us in concussion research feel very strongly that if you recognize the concussion, treat it appropriately, and don’t go back into competition too early, the brain heals itself. Those individuals don’t get into the chronic situation that has befallen a lot of athletes in their middle age.”
What Are Concussions?
In short, the medical field says that a concussion is a traumatic brain injury, which alters the way your brain functions. The affects may be temporary, and some of the symptoms may include headaches and problems with concentration, memory, balance and coordination. Interestingly, some of the common symptoms of concussions are often confused with dehydration, and racers believe they are suffering from a lack of hydration, but may actually be suffering from the effects of a concussion.
According to the experts, concussions often go undiagnosed, because they can occur without a blow to the head. They can happen whenever the head and upper body are violently shaken, like what happens when you run the Baja 1000 for hours on end. Thus, you don’t need to be involved in a serious crash to suffer a concussion. “Approximately 50 percent of the concussions in motorsports that I’ve studied don’t involve any head impact at all,” said Olvey. “What causes a concussion is not the impact, but angular acceleration. Where your brain is attached to the spinal cord is pretty stable, but as you go up in the higher levels of the brain, the brain can turn and twist and if it’s too violent you can do damage to the nerves of the brain. It’s the actual stretching of the nerve fibers that are damaging to the brain itself. In off-road racing they are bouncing around violently, and heads are being tossed back and forth. That in itself can cause a concussion.”
“I think that there are a lot of concussions that go unnoticed in off-road racing because the drivers and navigators can continue to function more out of a reflex than conscious thought,” said Olvey. “So if you’re out desert racing you might never know you had a concussion. It’s important to train the teams to know what to look for. If the driver starts to have erratic behaviors, or has a loss of skills by getting off course, are both symptoms.”
What Is CTE?
Researchers feel that CTE describes brain degeneration which is likely caused by repeated head traumas like concussions. CTE does not show up on an MRI or CT scan and there is no cure; at least not yet. Unfortunately, the big problem is that CTE cannot be diagnosed when the patient is alive. Doctors can only diagnose it in the brain after death. In theory, you may be walking around with CTE without knowing it. CTE is controversial, however, and there’s not enough science to make any predictions. If you or one of your team members have symptoms such as loss of memory, erratic behavior, emotional issues, physical or cognitive problems, and there’s a history of prior concussions, the logical thing would be to see a doctor.
Education in Concussions
Olvey insists that there should be education offered by sanctioning bodies in motorsports as 90 percent of the time, there is no loss of consciousness when a driver has a concussion. “In an off-road situation seeing sudden erratic behavior caused by a concussion can be a very bad deal,” said Olvey. “Remote monitoring systems aren’t really expensive, where you can monitor heart rate, respiratory rates and if those become abnormal then something might be happening neurologically with the driver. The crew might be able to check at the next pit stop.”
A Personal Story of Concussions
Julia Daly grew up in motorsports. Her dad was a weekend warrior who loved to race cars. She remembers the day he had a bad crash when she was a senior in high-school and he had a serious concussion. It took him months to recover from, as Daly recalls, because he was knocked unconscious.
The lack of proper care he got prompted her to study the subject more intensely when she later enrolled in Boston University. Today, she is an athletic trainer and is completing her doctorate in physical therapy.
“He didn’t get great care after his crash,” said Daly. “He was sent to the ER, but no one told him about recovery. They didn’t say don’t get back into the car. I think there’s a lot of misunderstanding about the seriousness of concussions by team owners and others. The doctors at local emergency rooms near race tracks may not know what’s involved in racing to offer a road to recovery for the patient.”
Her dad’s crash had a lasting effect on Daly, and while at the university she developed comprehensive protocols for recovery based on years of research. Daly is often a guest speaker alongside Olvey. “I created the protocols for a health professional to administer to a patient,” said Daly. “The protocol is written in medical terms, but my goal is to make it accessible to sanctioning bodies to ensure that those that suffer concussions can have the proper recovery. I’m still trying to get it distributed to the grassroots type racers, and that’s who needs it. Most of the drivers I have spoken with say they don’t know if they’ve had concussions, or they don’t necessarily want to admit it. They just want to keep racing and they don’t report it.”
Daly thinks that concussions are complex because a concussion is such a broad term. In general, the same amount of force to one person might cause a headache, and in the other person it might cause blurry vision. The symptoms of a concussion can be long-lasting or temporary and that where Daly’s protocols help because they can determine what level concussion the patient might have suffered.
Proper Safety Equipment
“Proper fitting helmets are designed to prevent skull fractures and structural damage, however by reducing the weight of the helmet, the potential for concussions caused from inertial forces can potentially be reduced as well,” according to Kelli Willmore of Impact Racing. “In recent studies, the weight of a helmet is given a tremendous amount of consideration and can contribute to a concussion. For this reason, Impact is continually researching methods that will cost-effectively reduce the weights of our helmets while exceeding required standards so the advantages are affordable to all racers in all forms of motorsports.”
Willmore emphasized that, “The future of helmet safety will likely see more integration of all the driver comfort and safety systems allowing for improved containment and a reduction in weight. Additionally, driver head nets, which are more commonly seen in IMSA sanctioned races as well as many forms of open wheel racing, do an incredible job of containing and mitigating inertial and lateral forces that could contribute to a concussion. Driver head nets are an extremely cost effective safety upgrade and do not interfere with a driver’s vision during competition or their ability to extricate themselves from a vehicle after a crash. “
Brain Is like a Car’s ECU
For the motorsports enthusiast, Daly put the term concussion in perspective by suggesting that a concussion may be similar to the electronics in a race car that can’t respond to the car’s engine. If the brain is injured it does not send signals to the body in the normal way it should. Just like the race car that experiences problems because the electronics (ECU) cannot communicate with the engine and fuel system so that it drives properly.
It is hoped that through education, safety gear, articles from SCORE and various post-concussion protocols for recovery that you can avoid becoming another statistic of those studying the causes of CTE.
To learn more about Daly’s concussion protocols email jndaly@bu.edu and she will send you her study, which should get you up to speed on concussions and recovery. SJ